[adamlinds]

Hi,

I just have a quick question in regards to Insulin/C-Peptide results.

Long story short, I was recently diagnosed with Celiac's Disease in the late stages. It had caused nerve damage enough to stop my heart (have pacemaker) and stopped my bone marrow function. Now I am ok and have been GF for 3 months, but I am having other issues. I have had on random blood results, low blood sugar after eating. I was sent to an Endo recently for this, who said my spleen was enlarged and he wanted to examine my pancreas with a CT because of my low BS and increased urination. THe fasting blood results came back showing my Insulin and C-Peptides abnormally low, but my blood sugar was around 4 (so low normal). My GP was confused with these results, as they expected increased Insulin. I haven't spoke to the Endo again, but I have a CT and Ultrasound next week.

My GP said she will contact the Endo to follow up on the low results. On the web I can't find much, can anybody fill me in on their experiences? I know Celiac is related to Type 1 Diabeties in Adulthood, but I don't have high blood sugar. I have a family history, but with Type 2. Any help is appreciated as I just would like to know what I may have to deal with since my Endo is busy and wont talk to me for awhile. Thanks in advance.

 

[wish]

I am very interested in learning more about Celiac Disease, adamlinds. I have been tested for that and return to the endo this week to find out. I don't have your problems, nor do I have the typical symptoms, but I've read that it can be brought on by surgery, and I had two surgeries last summer. I was diagnosed T2 this fall. I need to research more to learn about CPeptides, as well.

Would love to help, but I am learning, too. I will let you know what my endo says in relation to Celiac and Diabetes.

 

[Shanny]

My knowledge of celiacs is limited too, Adam, so I'm not much help. I do welcome you warmly, and am glad to have you join us.

Stay tuned and we may have some answers for both of you.

 

[adamlinds]

Thank you both for your responses

I am not too concerned with the Celiac relation actually. More confused at what would cause my Insulin and C-Peptides to be low (outside the referenced range on the lab), but blood glucose not being elavated. Also my blood sugar has been in the 2's many times...which is why i had this test, yet everything was low...confusing.

My tests coming up are for a tumor (insulinoma) which thank god isn't likely now with my levels being low and not high. Any information on these topics are greatly appreciated, thanks again to everyone for the welcome.

 

[Richard157]

Adam, I find those results confusing too. I wonder if the lab may have made a mistake? I am Type 1 and my C-peptide is less than 0.1 which means I produce virtually no insulin. Therefore my BG level is very high if I do not inject insulin. Do you know your actual C-peptide result? There is an ntirely different scale for measuring C-peptide. A 4 with BG is low normal, but a 4 with C-peptide is very high. Even a C-peptide of 2 suggests there is meaningful insulin production.

 

[adamlinds]

Finally got the blood results faxed to me, here are the numbers:

16 HOUR FAST
--------------------
Insulin - fasting : 23 PMOL/L (Ref range 30-175) <-- LOW
C-PEPTIDE : 186 PMOL/L (Ref range 298-2350) <--LOW
Glucose - fasting: 4.8 MMOL/L (Ref range 3-6)
Total Bilirubin : 18 UMOL/L (Ref range 0-23)
Cortisol AM : 374 NMOL/L (ref range 100-500)
LH Serum : 2.2 IU/L (Ref range 1 -8.8)
FSH Serum : 4.4 IU/L (Ref range 1.0 - 13.6)
Free Testosterone: 65 (Ref range 16 - 146)

I was seeing the endo for low blood sugar happening what seemed like at random. My normal 8hr fasting blood sugar is usually around 4 based on my old labs, but on non fasting occasions it was low sometimes (2-3). 4.8 is the highest fasting blood sugar I've ever had, especially after a 16 hr fast. The receptionist asks my endo and he said he wasn't alarmed and nothing needs to be done at this time. My GP disagrees. It seems weird to me to have such a low Insulin and C-peptide with a BG that is on the higher side as per my normal. Kind of disappointed the endo didn't at least explain to me why it was happening like that. Any insight is appreciated.

Thanks.

 

[Shanny]

(preliminary rant . . . as a crabby old granny, I'd be tempted to ask the endo what exactly is it he gets PAID FOR, if not ordering the tests and then explaining to his patients the meaning of their tests! rant over)

I really don't know sic 'em about this, Adam . . . the numbers seem incongruous to me. Is your GP consulting with the endo? And then adding in the thing with celiacs . . . why wouldn't the endo want to pursue this? Something doesn't add up . . .

Stay in touch.

 

[wish]

<finds herself liking shanny more and more everyday and plans a rant of her own soon if her endo is short on explanations>

 

[wish]

The diabetes numbers:
glucose , Bld range 790-99 MG/GL my score 86
my proinsulin was 19.5(H)...
insulin 36 (H)...
C-Peptide 5.5 (H)...

The endo just said this indicates that I am in fact insulin resistant and the actos was working. He would not need to increase that dosage just yet.

Do all those... indicate further info on another test/sheet. This is all I got. I got no ranges for anything except the glucose. I was not fasting for that test.

What do y'all think?

 

[Richard157]

Those numbers all lookm very impressive to me, even though three of them are labled as high. If you are insulin resistant then you must be at least borderline Type 2 . It is good that your Actos is working for you. Keep your weight under control and your A1c low and you may not have to use insulin and injections at all. Many Type 2's do eventually use insulin when their medication is no longer working so well. Some of them are using insulin pumps too.

 

[wish]

Richard, I agree and really feel like I was pretty borderline from the getgo. I am continuing to work hard on diet and exercise and appreciate the support I am getting here.

 

[jswede1149]

You have an anti-immunity condition (Celiac's). Were you tested for GAD65 and Islet? If not, please ask for this test.

Anti-immunity conditions appears in clusters. Type 1.5 diabetes make up is part insulin resistance. Many type 1.5's function fine on oral medication up to five years post diagnosis.

 

[wish]

I don't think I was tested for either of those things. The doctor has not even mentioned a problem with IgG score. I just found it when I asked for a copy of my labs. I believe I did not get copies of everything, though.

I will call the dr tomorrow. I am so not happy with him, but he's pretty much the only endo around.

Have you gotten any satisfaction from your dr?

 

[jswede1149]

Have you gotten any satisfaction from your dr?

No. I am between Endocrinologists. There are so few available through our insurance plan. All are booked out for months.

I've ran around since diagnosis without a sick plan.

We have to be our own medical advocates demanding to see our test results.

 

[wish]

I found the high test result for my BG myself after asking for a copy of my labs from my PCP. I asked about it, and they tested me multiple times, finally diagnosing me as T2. They had three fasting readings that were too high before I finally got them to do an A1C. I asked to be referred to an endo. He ran a bunch of tests but only addressed the diabetes and cholesterol numbers. No mention of the high IgG. I discovered that when I asked for a copy of my labs.

Yes, we definitely all need to be our own medical advocates. I am learning that the hard way.

 

[jswede1149]

I finally got them to do an A1C.

What was your A1C if I may ask?

My old Endocrinologist wrote in my file that she saw I had a 16 oz regular crush in the office. My DS was with me and we allow him to drink soda from time to time. She wrote that it was mine! She did not ask me.

I thought it was kind of odd when she demanded that I see a Dietitian and Educator. I refused. She called my husband and chewed him out. When the results of my A1C (12 to 6.7 in 6 months) and anti-bodies were returned, she back down.

Granted, there are many type 2's who do not take this disease seriously. I am sure she has seen many. However, it is not wise to accuse a patient and record it in their file. It was like eggs in her face when she realized I am a type 1. Never mind the fact that she never properly addressed my thyroid issues.

I wish I had an Endo to talk to while awaiting for my first appointment. I would rather wait than deal with her again :ballchain:

 

[wish]

MY PCP diagnosed me with an A1C of 6.95.

 

[Shanny]

My old Endocrinologist wrote in my file that she saw I had a 16 oz regular crush in the office. My DS was with me and we allow him to drink soda from time to time. She wrote that it was mine! She did not ask me.

I thought it was kind of odd when she demanded that I see a Dietitian and Educator. I refused. She called my husband and chewed him out. When the results of my A1C (12 to 6.7 in 6 months) and anti-bodies were returned, she back down.

Sometimes those notes tell more about the doctor than they do about the patient, eh?! I hope she also removed that remark from your chart, or at least annotated that is was an erroneous conclusion on her part.